Postoperative angiographic evaluation of gastroepiploic artery grafts: technical considerations and short-term patency.
Follow-up angiography was performed in 37 patients with right gastroepiploic artery (GEA) grafts at 27 +/- 32 days postoperatively. By the femoral approach, a 5F cobra or twist catheter was advanced selectively into the gastroduodenal artery (GDA) over a plastic-coated guidewire. In 29 patients, the GDA was successfully catheterized, and the GEA grafts were clearly visualized by the injection of 3-7 ml of contrast medium. GDA catheterization was unsuccessful in 8 patients, but in 4 of them the grafts were well visualized when 15-20 ml of contrast was injected. In the other 4 patients, visualization of the GEA grafts was poor, but the distal portions were outlined by retrograde perfusion from the native right coronary arteries. A total of 34 GEA grafts were patent (92%), and the diameters of these grafts were adequate when compared with respective recipient coronary arteries (2.8 +/- 0.9 and 2.3 +/- 0.6 mm, respectively; P less than .05). No complications were noted except for transient vasospasm (3 patients) in the GEA, hepatic artery, or both, which was relieved by the intra-arterial injection of isosorbide dinitrate (2.5 mg). Thus, the over-the-wire technique allows simple and safe GDA catheterization, which is essential for obtaining good visualization of GEA grafts.
Isshiki
T
T
Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan.
Yamaguchi
T
T
Nakamura
M
M
Saeki
F
F
Itaoka
Y
Y
Nagahara
T
T
Furuta
Y
Y
Ikari
Y
Y
Wanibuchi
Y
Y
Suma
H
H
D000328:Adult; D000368:Aged; D000792:Angiography / Q000009:adverse effects; D002404:Catheterization / Q000379:methods; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013270:Stomach / Q000098:blood supply*; D014654:Vascular Patency